LOCKED POSTERIOR DISLOCATION OF THE SHOULDER - TREATMENT USING ROTATIONAL OSTEOTOMY OF THE HUMERUS

This study reports the use of rotational osteotomy in 10 patients with locked posterior dislocation of the shoulder. The average interval be tween injury and diagnosis was 155 days (range, 21-400 days). Patients were aged 40-78 years old, with an average age of 53 years. Articular impaction fracture of the humeral head involved 20-40% of the articul ar surface as determined by CT analysis. There were no postoperative c omplications except a transient axillary nerve palsy. Patients were st arted on immediate passive motion followed by an active program at 2-3 weeks. Using the Rowe/Zarins scale, six patients had good-excellent r esults, two fair results, and two poor results. The poor results were seen in cases where articular cartilage damage was advanced. Rotationa l osteotomy is an effective procedure at restoring glenohumeral congru ity and early functional activity in the patient with locked posterior shoulder dislocation given the following criteria: (a) healthy articu lar cartilage, (b) a humeral head defect involving less than 40% of th e articular surface, and (c) a patient who is able to participate in a n active rehabilitation program.